1. Field of the Invention
The invention concerns a system for image-supported shockwave treatment
2. Description of the Prior Art
The main components of a system of the above type are a therapy system and an x-ray system. The therapy system includes a shockwave head that generates ultrasonic waves directed towards a focus point. The primary purpose of such a treatment is the disintegration of kidney and ureter stones. Other applications for treatment of Peyronie's disease or in the field of pain therapy and gastroenterology are also conceivable. The x-ray system serves for location of the stone in the treatment area of a patient and for observation of the treatment success accompanying therapy. It has an x-ray source and an x-ray receiver or image intensifier. Both devices are fixed on the ends of a c-shaped arc (called an x-ray C-arm in the following) that can move orbitally around its isocenter. In the application case the x-ray C-arm partially encompasses a patient table or is partially crossed by this in the direction of an axis running at a right angle to the orbital plane of said x-ray C-arm.
In the treatment of a patient with a system of the type illustrated above, the focus point of the shockwave head must be aligned on the isocenter of the x-ray C-arm or coincide therewith so that, given orbital or angular movement of the x-ray system required for 3D positioning, the beam axis of the x-ray system always proceeds through the focus point or through a volume region surrounding this focus point. In the application case, the therapy subject to be treated must correspondingly likewise be arranged in the aforementioned region, meaning that the patient must be suitably positioned on the patient table. In systems with stationary shockwave head, this requirement can only be satisfied by a position that is uncomfortable for the patient, for example by a prone position, which is particularly uncomfortable for adipose patients.
In a system known from DE 298 24 080 U1, a carrier device (fashioned as a C-arm) for a shockwave head is arranged in the orbital plane of an x-ray C-arm that can be only angularly moved. The C-arm has a first arc segment fixed on the x-ray C-arm and a second arc segment supported on the first fixed arc segment such that it can shift along this segment. The second arc segment carries the shockwave head on its free end. The first arc segment and the x-ray C-arm itself can be rotated around a common horizontal axis angularly running in the orbital plane and through the isocenter of the x-ray C-arm. Due to this embodiment, a shockwave head can be positioned both above and below a patient table. A disadvantage of this arrangement is that the space circumscribed by the x-ray C-arm is crowded by the carrier device such that a displacement of the patient table running horizontal and parallel to the orbital plane operating system is barely possible. Given a change from a left-side treatment position to a right-side treatment position, with an unchanged patient position, the patient volume therefore cannot be brought into the focus point or the isocenter via a table displacement. Rather, a head-to-foot rearrangement of the patient is necessary. The result is that the previous spatial orientation must be adapted to the new patient position; for example, a time-consuming reconstruction of auxiliary devices (such as anesthesia devices) must be effected.